The combination of ultrasound with antibiotics released from bone cement decreases the viability of planktonic and biofilm bacteria: an in vitro study with clinical strains.

Abstract

OBJECTIVES:

Antibiotic-loaded bone cements are used for the permanent fixation of joint prostheses. Antibiotic-loaded cements significantly decrease the incidence of infection. The objective of this study was to investigate whether the viability of bacteria derived from patients with a prosthesis-related infection could be further decreased when antibiotic release from bone cements was combined with application of pulsed ultrasound.

METHODS:

Escherichia coli ATCC 10798, Staphylococcus aureus 7323, coagulase-negative staphylococci (CoNS 7368 and CoNS 7391) and Pseudomonas aeruginosa 5148 were grown planktonically in suspension and as a biofilm on three different bone cements: Palacos R without gentamicin as control, gentamicin-loaded Palacos R-G and gentamicin/clindamycin-loaded Copal. The viability of planktonic and biofilm bacteria was measured in the absence and presence of pulsed ultrasound for 40 h.

RESULTS:

Ultrasound itself did not affect bacterial viability. However, application of pulsed ultrasound in combination with antibiotic release by antibiotic-loaded bone cements yielded a reduction of both planktonic and biofilm bacterial viability compared with antibiotic release without application of ultrasound.

CONCLUSIONS:

This study shows that antibiotic release in combination with ultrasound increases the antimicrobial efficacy further than antibiotic release alone against a variety of clinical isolates. Application of ultrasound in combination with antibiotic release in clinical practice could therefore lead to better prevention or treatment of prosthesis-related infections.

• Authors: Geert T Ensing, Daniëlle Neut, Jim R van Horn, Henny C van der Mei, Henk J Busscher
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 58 Issue 6 Pg. 1287-90 (Dec 2006) ISSN: 0305-7453 [Print] England
• PMID: 17041238 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Bone Cements
• Gentamicins
• Clindamycin

Topics

• Anti-Bacterial Agents (metabolism, pharmacology)
• Bacteria (drug effects)
• Biofilms (drug effects, growth & development)
• Bone Cements (chemistry)
• Clindamycin (pharmacology)
• Colony Count, Microbial
• Gentamicins (pharmacology)
• Microbial Viability
• Ultrasonics